Girl Scout Troop 2573

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Circle your gender:  Female or Male

 

Circle your grade:  9th 10th 11th 12th

 

 

1. I am confident in my knowledge of how to keep myself out of an unsafe situation.

 

Don’t agree     1          2          3          4          5          Strongly agree

 

 

2. I believe that I have the skills to recognize an unsafe situation.  

 

Don’t agree     1          2          3          4          5          Strongly agree

 

 

3. I believe that I have basic skills to help get myself out of an unsafe situation.

 

Don’t agree     1          2          3          4          5          Strongly agree

 

 

4. I feel that I am able to communicate to a date or a friend or a stranger clearly (so that they understand) my physical boundaries.

 

Don’t agree     1          2          3          4          5          Strongly agree

 

 

5. I believe that assault is common among teens my age.  

 

Don’t agree     1          2          3          4          5          Strongly agree

 

 

6. I know the legal steps to take in case a friend or I have been sexually assaulted.

 

Don’t agree     1          2          3          4          5          Strongly agree

 

 

7. Any other comments?